Top pediatric specialists added their voices Monday to those of Indigenous leaders to demand the Quebec government reverse its antiquated policy of barring parents from accompanying sick and injured children on medical evacuation flights to hospitals.

There has to be a better way — the policy is cruel to children and their parents, emergency room doctors at CHU Sainte-Justine children’s hospital and the Canadian Paediatric Society (CPS) said in separate open letters.

Routinely blocking family members from accompanying gravely ill children who are airlifted to Montreal fails to reflect a standard care available in the rest of Canada, the physicians said.

Although this policy applies to all Quebec children, Indigenous children and families from northern Quebec are disproportionately affected, said Dr. Radha Jetty, chair of the CPS First Nations, Inuit and Métis Health Committee, because the only way in and out of Nunavik’s 14 isolated villages is by plane. Forced removal of children recalls the residential school system and tuberculosis epidemic, she added.

At least once a week a child is airlifted from Gaspé and other regions of Quebec, said CPS president-elect Catherine Farrell, a physician in Sainte-Justine’s intensive care unit.

“It’s so important for the parent to be present — and also for the medical team to have the parent be part of the decision-making that takes place around sometimes very critical decisions when a child is being airlifted,” said Farrell, who has the approval of the Association des pédiatres du Québec (APQ).

The CPS threw its support behind the Montreal Children’s Hospital, which in December sent the first letter lobbying for change. The no-family policy on the Challenger, the “hospital plane,” has been in place for decades, said Children’s emergency room physician Samir Shaheen-Hussain, who spearheaded the call to action after a disturbing experience last summer.

Shaheen-Hussain was treating a preschool Inuk boy who had fallen off an ATV. The boy may have suffered brain trauma. He was crying inconsolably. Only once an interpreter was brought in did staff understand: he was crying for his mother.

And there were other cases of children without their parents, such as the toddler left unsupervised who fell from her crib in the emergency room. Another child awoke alone and frightened, and then left the hospital.

“I feel as if I failed these children for not acting earlier,” Shaheen-Hussain told the Montreal Gazette in earlier interviews.

The disturbing situation reported by the Montreal Gazette and La Presse led a group of doctors at CHU Sainte-Justine children’s hospital to show solidarity in denouncing a terrible policy, said emergency room physician Laurence Alix-Séguin, who penned Monday’s letter signed by two of her colleagues, including the medical chief of Sainte-Justine’s emergency room.

The problem is not with Évacutation aéromédicales du Québec (ÉVAQ), which is providing essential services, but with a government policy that systematically rejects parents aboard the air ambulances, said Alix-Séguin, who specialized in Australia and France in airlifting sick children, always with a parent or caregiver along.

“You know it can be hard to leave a healthy child at daycare. Now imagine during a medical crisis,” she said.

Alix-Séguin noted that for two decades, there has been real effort to integrate key decision makers, the parents, in every stage of care, including during reanimation procedures when a child is near death. A parent offers comfort and support, and their presence, as studies have shown, can lessen a child’s fear, anxiety and pain, she said.

“The same approach should apply during a medical evacuation,” Alix-Séguin said. “Sending a child far from home in a difficult environment like an air ambulance causes major stress for the child.”

Not only are parents best at comforting an anxious child, but their absence causes barriers. It denies them the right to be informed of the nature and risks of critical treatment. As the Montreal Children’s Hospital doctors noted, discussing medical procedures with parents is essential to good care, but caregivers are often not available because they are on the next commercial flight.

It’s not normal to ask parents to abandon their gravely ill children to strangers, Alix-Séguin said. In some cases, the children’s conditions deteriorate during the flight. Some die alone.

“Everyone stands to benefit from having a parent during an airlift,” she said.

ÉVAQ has said it is re-evaluating its policy. Quebec Health Minister Gaétan Barrette said he would reconsider the policy, but doubted much could be done given the logistics of providing emergency care in a tight space with limited resources, coupled with air-transport safety regulations.

Looking after a sick child while accommodating a parent in restricted space such as the Challenger is an undertaking, Alix-Séguin said, but in order to respect the fundamental rights of a child not to be separated from his family, government must focus on removing such obstacles.

The Health Department will take stock of the letters before responding, said Barrette’s press attaché, Catherine Audet.

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